This post was originally published at Barton Associates.
Oregon’s state legislators recently passed a law designed to streamline the credentialing process for all healthcare organizations in the state. The bill, SB 604, requires the Oregon Health Authority establish an electronic database by 2016 that will contain all the information needed to credential a healthcare practitioner. All credentialing organizations, including hospitals and healthcare organizations, will have access to the database. The bill creates a system that is similar to neighboring Washington’s electronic credentialing system, except for one major difference. Oregon’s system is compulsory.
“When you don’t require something, and it doesn’t get used, you’re not really making a difference,” Jean Steinberg, CPCS, CPMSM, director of medical staff services for St. Charles Health System in Bend, OR, told HealthLeaders Media.
The news of a state-wide credentialing system may not be good news for locum tenens practitioners. Oregon is actually the second state in the country to require all healthcare providers use the state-managed credentialing body. Arkansas has its Centralized Credentials Verification Service (CCVS), which all organizations credentialing physicians for Arkansas and all physicians licensed in Arkansas must use. The CCVS system has done little to speed up the credentialing process in Arkansas. If anything it has made it worse. Whitney Jordan, credentialing manager at Barton Associates, says the turnaround time for Arkansas is one of the longest in the country, mainly due to the lack of staffing available at the state medical board and the lengthy CCVS process.
Time will tell if Oregon’s process will be quicker. Oregon’s lawmakers have two years to iron out the details of their new system, including how closely the system will scrutinize the information entered by each physician. Steinberg predicts that many organizations, including her own, will continue to independently verify physician information when credentialing a new physician, which means physicians may need to go through two credentialing processes, one for the state and one for the facility, before they can practice.
Company’s unique portfolio of solutions enable physician offices to maximize profitability and productivity
“Our goal is to support physicians and their practices by enabling them to focus on medicine and maximize profitability while ClinicSpectrum’s solutions automate their billing and collection processes,” explained Vishal Gandhi, chief executive officer, ClinicSpectrum. “With AutoCollectSpectrum, we can readily help practices benefit from the changes brought on from healthcare reform.”
AutoCollectSpectrum is an automated program to expedite the collection of deductibles and other balances owed. The patent-pending and proprietary collection method uses automated secure text, patient portals and other messaging channels in place of traditional phone calls, and hard copy, mailed letters. By eliminating the representative involvement and automating the process, physicians reduce the cost and time involved with retrieving payments.
Other products in the ClinicSpectrum portfolio that also help enhance efficiency and maximize revenue include EligibilitySpectrum, as well as the patent-pending ProductivitySpectrum, InvoiceSpectrum and CredentiallySpectrum.
EligibilitySpectrum – With the enormous influx of patient deductibles in the health insurance market place, EligibilitySpectrum enables practices to readily manage the complete eligibility of all patients by combining software and back-office operations resources. The options include using a real-time connection with a clearing house, insurance companies’ websites, or live calls conducted by ClinicSpectrum’s eligibility team. This product interfaces via an API with any EHR / scheduling system.
ProductivitySpectrum – Focused on benchmarking on various tasks and instilling self-accountability through daily reporting, this product calculates employee desk time and reduces ideal time or non-productive time. It provides comparative analysis with respect to industry and / or office benchmarks, and expected weekly or monthly productivity.
InvoiceSpectrum – By using a unique payment and invoice processing rule setup for auto-fax, auto-email, auto-credit card processing and auto-paper statement processing, practices will benefit from saving time on template creation, follow-up and more. Additionally the product provides monthly forecast management, receivable management and sales force productivity examination for better cost/profit analysis.
CredentialingSpectrum – CredentialingSpectrum is an automated tool for the credentialing of providers’ profiles and insurance participation, as well as for contract management. It allows users to import CAQH summaries for faster data entry of a provider’s profile, and also auto populates participation application forms from most insurances. It also has a built in document management, task management, milestone management, and reminder functionality for expiration of various documents and credentials, as well as communication templates and messaging solutions for automated calls, secure email, secure text and fax. For more information about ClinicSpectrum or any of their physician practice products, please visitwww.ClinicSpectrum.com.
ClinicSpectrum is a healthcare services company providing outsourcing/back-office and technology solutions for 17+ medical billing companies, 600+ medical groups/healthcare facilities including hospitals, and hospital medical records departments.
The company is promoted by technical experts from diversified industries. In a span of 12 years, ClinicSpectrum has been able to transform several billing companies and healthcare facilities nationwide with unprecedented efficiency. The company’s strategy is to build productivity through the use of technology, highly trained personnel who deliver results in a timely fashion, and customized consulting services. ClinicSpectrum has created a solution for all the problems in running a medical billing company and medical practice resulting in better clinical records, revenue cycle, and administrative task management. For more information, e-mail Vishal@Clinicspectrum.com or visit www.ClinicSpectrum.com.
The Follow-Up process is divided into 3 methods:
Online Claims Follow-Up – Using various Insurance company websites and internet payer portals we check on the status of outstanding claims.
Automated Claims Follow-Up (IVR) – By calling Insurance companies directly an Interactive Voice response system will give the status of unpaid claims.
Insurance Company Representative – If necessary calling a “live” Insurance company representative will give us a more detailed reason for claim denials when such information is not available from either websites or Automated phone systems.